维吾尔族老年反流性咽喉病病人临床症状及其嗓音声学指标观察

Study of clinical symptoms and voice acoustic analysis in Urmuqi elderly patients with laryngopharyngeal reflux disease

目的观察维吾尔族老年反流性咽喉病(laryngopharyngeal reflux disease,LPRD)病人治疗后临床症状及嗓音声学特征指数的变化情况。方法选择我院耳鼻咽喉科门诊就诊的100例维吾尔族老年LPRD病人(排除咽喉占位性病变)作为研究对象(LPRD组);选择同期100例体检合格的健康老年维吾尔族志愿者作为对照组,所有对象均行动态频闪喉镜检查。采用德国XION DIVAS嗓音测试分析系统检测2组受试者的嗓音相关指标:基频微扰(Jitter)、振幅微扰(Shimmer)、声压级(SPL)、最长发声时间(MPT)、最大基频(FOmax)、最小基频(FOmin)、嗓音障碍指数(DSI)。观察LPRD组治疗后的反流症状指数(RSI)评分、反流体征指数(RFS)评分和嗓音相关指标,并与对照组进行比较。结果治疗后,LPRD组病人声音嘶哑、咽部异物感及反酸烧心感等不适均有明显好转,RSI和RFS评分均恢复至正常参考值范围内,且与对照组比较差异无统计学意义(P<0.05)。治疗后3月随访发现,与对照组比较,LPRD组的基频微扰显著增高,DSI均值显著降低,2组比较差异有统计学意义(P<0.05)。结论 LPRD可能导致老年病人声带病理改变而造成嗓音损害。

Objective To observe the clinical symptoms and voice acoustic analysis in Urmuqi elderly patients with laryngopharyngeal reflux disease（ LPRD）. Methods 100 cases of Uygur elderly outpatients with LPRD（ excluding throat lesions） in our hospital were enrolled as LPRD group,and 100 healthy Uygur elderly volunteers were selected as the control group. All the patients underwent dynamic stroboscopic laryngoscopy. The XION DIVAS voice test and analysis system was used to detect the continuous vowel/e：/signal in the two groups,and the voice-related indicators such as fundamental frequency perturbation（ Jitter）,amplitude perturbation（ Shimmer）,sound pressure level（ SPL）,maximum phonation time（ MPT）,maximal fundamental frequency（ FOmax）,minimal fundamental frequency（ FOmin）,voice dysphonia severity index（ DSI） were detected. The reflux symptom index（ RSI）,reflux find score（ RFS） and voice-related indicators of LPRD group were obsereved after treatment. Results After treatment,the hoarseness and pharyngeal foreign body sensation,heartburn discomfort were obviously improved.The average scores of RSI and DFS recovered to the normal range in LPRD group,which showed no significant difference with contol group. The fundamental frequency perturbation was significantly increased and the level of DSI was significantly decreased in LPRD group than those in the control group after 3 months of treatment（ P〈0. 05）. Conclusions LPRD may lead to voice damage due to vocal cord pathological change in elderly patients.